Immune dysfunction is a hallmark of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). The purpose of this pilot study was to identify the effects of influenza vaccination on immune function in patients with CFS/ME. We included 7 patients meeting the Centre for Disease Control and Prevention criteria (CDC 1994) for ME/CFS and 8 control subjects. Bloods were collected from all participants prior to vaccination with Influvac, a trivalent inactivated influenza vaccine (TIV), 14 and 28 days following vaccination. The immune parameters examined include Natural Killer (NK) phenotypes, NK cytotoxic activity, FOXP3 and Th1/Th2/Th17 related cytokines. Flow cytometric protocols were employed. There was no significant difference in NK phenotypes and Tregs numbers between CFS/ME patients and healthy controls. However, NK activity was significantly decreased at baseline and at 28 days, while at 14 days it significantly increased in the CFS/ME patients compared to the healthy controls. Th1 pro-inflammatory cytokines increased considerably in the CFS/ME patients at 28 days compared to the non-fatigued controls. Only one Th2 cytokine, IL-4, increased in the CFS/ME participants. FOXP3 expressing Tregs only increased significantly at day 28 post vaccination in the CFS/ME patients compared to the healthy controls. Self-rated wellbeing was lower for patients at day 28 while at baseline and day 14 no differences were observed. In this pilot study immunization with influenza vaccine is accompanied by a degree of immune dysregulation in CFS/ME patients compared with controls. While vaccination may protect CFS/ME patients against influenza, it has the ability to increase cytotoxic activity and pro-inflammatory reactions post vaccination. The role of Tregs in promoting a toxic effect at 28 days post-vaccination in our patient group cannot be ruled out. The benefits of influenza vaccine still likely outweigh the risks CFS/ME patients experience following vaccination.

The benefits of influenza vaccine still likely outweigh the risks CFS/ME patients experience following vaccination.

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It's neither a condemnation of influenza vaccination for PWME, nor a whole-hearted endorsement.

It appears we have more trouble with the flu vaccine than the average person, but not a serious enough reaction to suggest we should not take the flu vaccination (as a general rule). This study probably shows the simple reality of living with ME/CFS -- everything is tougher for us. In this case, we (in general) probably need the flu vaccine, BUT we'll have a more noticeable reaction to it than most people. This illness sucks.

Though I have never been as bad as I am now. So not sure if I should take it again.

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That's one of the many problems for us -- do we take vaccines or not? Most of the top docs are saying you should take killed virus vaccines, but not live virus vaccines....BUT if you had a bad reaction to a particular vaccine in the past, you should consider if the vaccine is worth the reaction you had before you take it again. Lots of help, eh?

Lots of us get worse in Nov/Dec, so I wouldn't necessarily attribute that to the vaccine. It might be that, of course, but it might also be multiple exposures to colds, flu, and other winter bugs. Or something else entirely like reduction in vitamin D from less sunlight. Or who knows what? ME/CFS -- always a new adventure in misery.

It's neither a condemnation of influenza vaccination for PWME, nor a whole-hearted endorsement.

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They'll never make a statement opposing vaccine use for pretty much anyone.

The general take away from these sorts of studies is "Yeah, flu vaccines do some weird stuff to the immune system of ME patients. We don't know what's happening, or how long it lasts, but get vaccinated anyway!"

In my opinion it is the live-attenuated vaccines that are risky and the risk is similar to getting the virus itself - the risk of inducing the immunological changes involved in maintaining or worsening ME symptoms.

Vaccines during cancer treatment
People with weak immune systems can get some vaccines, but they should not get vaccines that contain live virus. Fatal infections have been caused by giving live-virus polio, measles, and smallpox vaccines to people with weak immune function.

It’s generally recommended that vaccines not be given during chemo or radiation treatments — the only exception to this is the flu shot. This is because vaccines need an immune system response to work, and you may not get an adequate response during cancer treatment.

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Polio and smallpoxPolio vaccine: Childrenwho have weak immune systems, as well as their siblings and others who live with them, only should get inactivated polio virus vaccines. Most doctors in the United States use only the inactivated polio vaccine, but you can ask to be sure. The older oral polio virus vaccine (which is taken by mouth) contains a live virus. People who get the live virus vaccine can pass the poliovirus on to people with weak immune systems.

Smallpox vaccine: In general, people with weakened immune systems should not get the smallpox vaccine. Household members of those with weak immune systems should not get it either. There are many other restrictions and exceptions on how this vaccine is used. To learn more about smallpox vaccination, see our document calledSmallpox Vaccine and Cancer.

I live with somebody who has a weakened immune system. If I have the vaccine, is there a risk that the bacteria in the vaccine could infect them?
No. While the BCG vaccine is not recommended for people with a weakened immune system, they cannot catch TB from someone who has been vaccinated.

@Grigor I hear you man. My ME was triggered by a flu shot in November of 2011.

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Hello, I am very interested in how your flu shot got you ME. If you don't mind, could you share the timeline...also, do you remember the type of flu shot that you got, thanks. Did you get a flu after the shot?

Hello, I am very interested in how your flu shot got you ME. If you don't mind, could you share the timeline...also, do you remember the type of flu shot that you got, thanks. Did you get a flu after the shot?

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I don't remember which type it was. I got it on November 10th 2011 and felt weird right away. Then the acute flu or virus or reaction from the shot happened on November 20th 2011.

I don't remember which type it was. I got it on November 10th 2011 and felt weird right away. Then the acute flu or virus or reaction from the shot happened on November 20th 2011.

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Do you know if you only got the killed flu virus vaccine? Sometimes they give the pneumovax at the same time which is known to cause a hypersensitivity rxn in some patients. It gave me a lot of trouble when the preservative-free, killed virus flu vaccine doesn't. Everybody is different, of course.

Do you know if you only got the killed flu virus vaccine? Sometimes they give the pneumovax at the same time which is known to cause a hypersensitivity rxn in some patients. It gave me a lot of trouble when the preservative-free, killed virus flu vaccine doesn't. Everybody is different, of course.

Pretty sure it was just the dead virus flu shot without any additional vaccines. And it was a shot, not the nasal vaccine. Were your ME's triggered by vaccines or did you have one within 20 days of onset?

Pretty sure it was just the dead virus flu shot without any additional vaccines. And it was a shot, not the nasal vaccine. Were your ME's triggered by vaccines or did you have one within 20 days of onset?

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No, my ME was not triggered by a vaccine. I did have a significant setback when I had a flu shot (with preservatives) and the pneuomovax at the same time, but I was years into ME at that point. Since then I've had the killed virus preservative-free flu shot with no problem at all. Same with my daughter who also has ME. That doesn't mean everyone with ME can take the flu shot without consequences, of course.